Outcomes of endodontic therapy in general practice

A study by the practitioners engaged in applied research and learning network

Susan D. Bernstein, Allan J. Horowitz, Martin Man, Hongyu Wu, Denise Foran, Donald A. Vena, Damon Collie, Abigail C. Matthews, Frederick A. Curro, Van P. Thompson, Ronald Craig

Research output: Contribution to journalArticle

Abstract

Background: The authors undertook a study involving members of a dental practice-based research network to determine the outcome and factors associated with success and failure of endodontic therapy Methods: Members in participating practices (practitioner-investigators [P-Is]) invited the enrollment of all patients seeking treatment in the practice who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years previously. If a patient had more than one tooth so treated, the P-I selected as the index tooth the tooth treated earliest during the three- to five-year period. The authors excluded from the study any teeth that served as abutments for removable partial dentures or overdentures, third molars and teeth undergoing active orthodontic endodontic therapy. The primary outcome was retention of the index tooth. Secondary outcomes, in addition to extraction, that defined failure included clinical or radiographic evidence (or both) of periapical pathosis, endodontic retreatment or pain on percussion. Results: P-Is in 64 network practices enrolled 1,312 patients with a mean (standard deviation) time to follow-up of 3.9 (0.6) years. During that period, 3.3 percent of the index teeth were extracted, 2.2 percent underwent retreatment, 3.6 percent had pain on percussion and 10.6 percent had periapical radiolucencies for a combined failure rate of 19.1 percent. The presence of preoperative periapical radiolucency with a diagnosis of either irreversible pulpitis or necrotic pulp was associated with failure after multivariate analysis, as were multiple canals, male sex and Hispanic/Latino ethnicity. Conclusions: These results suggest that failure rates for endodontic therapy are higher than previously reported in general practices, according to results of studies based on dental insurance claims data. Clinical Implications: The results of this study can help guide the practitioner in deciding the most appropriate course of therapy for teeth with irreversible pulpitis, necrotic pulp or periapical periodontitis.

Original languageEnglish (US)
Pages (from-to)478-487
Number of pages10
JournalJournal of the American Dental Association
Volume143
Issue number5
StatePublished - May 2012

Fingerprint

Endodontics
General Practice
Tooth
Learning
Research
Pulpitis
Percussion
Therapeutics
Retreatment
Hispanic Americans
Dental Insurance
Periapical Periodontitis
Research Personnel
Overlay Denture
Removable Partial Denture
Pain
Third Molar
Orthodontics
Multivariate Analysis

Keywords

  • Endodontic therapy
  • Practice-based research
  • Root canal
  • Treatment outcome

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Outcomes of endodontic therapy in general practice : A study by the practitioners engaged in applied research and learning network. / Bernstein, Susan D.; Horowitz, Allan J.; Man, Martin; Wu, Hongyu; Foran, Denise; Vena, Donald A.; Collie, Damon; Matthews, Abigail C.; Curro, Frederick A.; Thompson, Van P.; Craig, Ronald.

In: Journal of the American Dental Association, Vol. 143, No. 5, 05.2012, p. 478-487.

Research output: Contribution to journalArticle

Bernstein, SD, Horowitz, AJ, Man, M, Wu, H, Foran, D, Vena, DA, Collie, D, Matthews, AC, Curro, FA, Thompson, VP & Craig, R 2012, 'Outcomes of endodontic therapy in general practice: A study by the practitioners engaged in applied research and learning network', Journal of the American Dental Association, vol. 143, no. 5, pp. 478-487.
Bernstein, Susan D. ; Horowitz, Allan J. ; Man, Martin ; Wu, Hongyu ; Foran, Denise ; Vena, Donald A. ; Collie, Damon ; Matthews, Abigail C. ; Curro, Frederick A. ; Thompson, Van P. ; Craig, Ronald. / Outcomes of endodontic therapy in general practice : A study by the practitioners engaged in applied research and learning network. In: Journal of the American Dental Association. 2012 ; Vol. 143, No. 5. pp. 478-487.
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